Long-term effect of communication training on the relationship between physicians’ self-efficacy and performance

Abstract

Objective To examine the long term impact of a communication skills intervention on physicians' communication self-efficacy and the relationship between reported self-efficacy and actual performance. Methods 62 hospital physicians were exposed to a 20-hour communication skills course according to the Four Habits patient-centered approach in a crossover randomized trial. Encounters with real patients before and after the intervention (mean 154 days) were videotaped, for evaluation of performance using the Four Habits Coding Scheme. Participants completed a questionnaire about communication skills self-efficacy before the course, immediately after the course, and at 3 years follow-up. Change in self-efficacy and the correlations between performance and self-efficacy at baseline and follow-up were assessed. Results Communication skills self-efficacy was not correlated to performance at baseline (r=-0.16; p=0.22). The association changed significantly (p=0.01) and was positive at follow-up (r=0.336, p=0.042). The self-efficacy increased significantly (effect size d=0.27). High performance after the course and low self-efficacy before the course were associated with larger increase in communication skills self-efficacy. Conclusion A communication skills course led to improved communication skills self-efficacy more than three years later, and introduced a positive association between communication skills self-efficacy and performance not present at baseline. Practice implications Communication skills training enhances physicians' insight in own performance.

Communication Skills Training for Physicians Improves Patient Satisfaction

“…15 However, the majority of studies have been small (< 130 physicians) and have not demonstrated statistically significant improvements in inpatient or outpatient experience or satisfaction measures. [20][21][22][23][24] In addition, many of these training efforts have been confined to specific populations [25][26][27][28][29][30][31][32] or have been with trainees. [33][34][35][36][37] To date, more complex interventions and/or courses aimed at specific conditions have shown the greatest likelihood of improving patient experience.…”

Physicians’ attitudes toward unhealthy alcohol use and self-efficacy for screening and counseling as predictors of their counseling and primary care patients’ drinking outcomes

“…Another possible route is that physicians’ self-efficacy alone has a direct effect on whether or not physicians screen and counsel patients. However, most studies which have examined primary care physicians’ self-efficacy have focused on self-efficacy for general communication skills, not specifically screening and counseling about alcohol use [9]. It is not known whether self-efficacy and attitudes both play a role in screening and counseling for unhealthy alcohol use, or whether self-efficacy alone can predict screening and counseling for unhealthy alcohol use—both of which, in turn, can lead to improved patient outcomes.…”

Do I Buy It? How AIDET™ Training Changes Residents' Values about Patient Care

“…Current models, such as The Four Habits Model, are now addressing these behavioral tasks and matching them to evaluations. 12 In this training model, physicians are taught about communication skills in four broad categories: 1) Invest in the beginning, 2) Elicit the patient's perspective, 3) Demonstrate empathy, and 4) Invest in the end. There is now the Four Habits Coding Scheme, which is an instrument derived from this teaching model.…”

“…Previous research has shown that communication skills training increases self-efficacy up to three years later and increases performance up to a year later. 12 …”